Parasitic Infections and their Association with Cytokine Levels in Children with Haemoglobinopathies in Rural Ghana

Abstract

In Sub-Saharan Africa, the overlap of Sickle cell disease (SCD) and neglected tropical diseases (NTDs), mostly soil transmitted helminth infections and schistosomiasis are common. NTDs can exacerbate SCD crisis, as they have been shown to cause severe complications or chronic organ dysfunction leading to crisis conditions in SCD patients. This research sought to assess the prevalence with infection of NTDs and their association with cytokine level in children with haemoglobinopathies. Haemoglobinopathies and presence of the helminths were determined from the blood and stool samples respectively. Out of the 327 participants recruited, normal haemoglobin genotype (AA) constituted 68.9 %, 14% were traits (AS) and 3% had an either of the following genotypes (SS/SF/SC/CC). Other genotypes detected were AC/ACF (14%). The overall prevalence of helminths (Ascaris sp, Ancyclostoma duodenale, Strongyloides sp, Trichuris sp and Schistosoma sp) in the two communities was 39%. IL-6 levels were found to be elevated in Hb SS/SF groups as compared to the other haemoglobinopathies (AA/AF, AC/ACF and SC). IL8 levels were not significantly different among the various haemoglobinopathies. These findings therefore support the role inflammatory cytokines (IL 6 & IL 8) play as predictive markers of crisis in sickle cell children. Study recommends an increase in control/preventive practices to reduce the burden of helminths in all groups of children in the selected communities.